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Long Term Clinical and Visual Outcomes of Retrofixated Iris Claw Lenses Implantation in Complicated Cases
摘要： Aims: To evaluate the visual outcomes and complications after implantation of retrofixated iris claw (RFIC) lens in various challenging situations. Settings and Design: Retrospective, single centre, 8 year clinical audit. Materials and Methods: A retrospective analysis of cases who underwent RFIC lens implantation alone (group 1) or in combination with vitreoretinal (VR), corneal or glaucoma procedures (group 2) was performed. The main outcomes evaluated were corrected distant visual acuity (CDVA) and postoperative complications. The mean follow up was 13.09±6.8 (range 6-24) months. Results: The study involved 100 eyes of 83 patients with mean age of 51.1±25.4 years. Group 1 included 59 eyes and group 2 had 41 eyes. In group 1, the mean CDVA improved from 0.86±0.81 to 0.38±0.51 LogMAR (p<0.001) with 72.8% eyes having gain in lines (≥ 2 lines) of CDVA with safety index of 1.73. The mean CDVA in group 2 improved from 0.71±0.65 to 0.38±0.34 LogMAR (p=0.003) with 65.8% eyes having gain in lines (≥ 2 lines) of CDVA with a safety index of 1.54. Group 2 showed a higher complication rate of 36.59% compared to group 1 (20.34%). Significant complications noted were secondary glaucoma (8%), disenclavation of haptic (4%), subluxation of RFIC lens (1%). Conclusion: The visual outcome with RFIC lenses when combined with other intraocular procedures is mainly affected by the complexity of co-existing pathologies .The complications are more related to the combined procedures performed rather than RFIC lens implantation alone. This may still be acceptable when complication profile of other intraocular lenses is evaluated in similar challenging situations.
关键词： iris claw,enclavation,vitreoretinal,Combined,intraocular lens,retrofixated
更新于2025-09-23 15:23:52
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Incidence of posterior capsular opacification requiring Nd:YAG capsulotomy after cataract surgery and implantation of enVista? MX60 IOL
摘要： Purpose. — To evaluate incidence of posterior capsule opacification requiring Nd:YAG capsulotomy over 3 years in a large series of eyes implanted with the enVista? MX60 Intraocular Lens (IOL). Methods. — A university-based, single-center, observational study of patients’ medical records was conducted. Uneventful cataract surgery patients with in-the-bag implantations of the enVista? MX60 IOL with a minimum of 24 months follow-up were included in the study. Exclusion criteria were insufficient follow-up (< 24 months), intraoperative complications and combined surgery. The primary outcome measure was rate of YAG laser capsulotomy, while secondary outcome measures were time to YAG laser capsulotomy and rate of glistenings. Results. — A total of 245 eyes of 143 patients received the MX60 IOL and were followed in the same center. Of these, 226 eyes were included in the study. Mean age was 80.7 ± 8.3 years and M/F ratio was 42/101 (29.4/70.6%). The mean preoperative distance (logMAR) visual acuity was 0.67 ± 0.5, while postoperatively it was 0.31 ± 0.5 at the last visit. The Mean follow-up time (min-max) was 35.2 ± 7.2, (24—48.4) months. The incidence of Nd:YAG capsulotomy over 3 years was 5/226 (2.2%). Average time between surgery and Nd:YAG capsulotomy was 32.17 months. Univariate analysis of age, gender, presence of comorbidity and baseline visual acuity found no predictive factors for capsulotomy. No glistenings were reported at any postoperative visit. Conclusion. — The three-year cumulative incidence of PCO requiring Nd:YAG laser capsulotomy was 2.2% for the enVista? MX-60 IOL, with no glistenings observed during follow-up. This low rate confirms the excellent safety profile of this IOL.
关键词： Cataract surgery,Intraocular lens,Posterior capsule opacification,MX60,Glistening
更新于2025-09-23 15:23:52
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Resultados visuales, independencia de gafas e insatisfacción tras implante de una lente intraocular difractiva trifocal
摘要： Purpose: To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. Methods: A retrospective study conducted on 5,186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). Results: The mean pre-operative keratometry was 43.61 ± 1.55 D, and mean keratometric cylinder was -0.86 ± 0.66 D. At 3 months post-operatively, values changed to 43.59 ± 1.56 and -0.71 ± 0.46 D, respectively. Mean sphere varied from 2.04 ± 2.60 to 0.14 ± 0.38 D, and mean spherical equivalent from 1.64 ± 2.61 to -0.05 ± 0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). Conclusions: The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction.
关键词： Trifocal,Intraocular lens,Multifocal,Dissatisfaction,Satisfaction
更新于2025-09-23 15:23:52
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Microscopic analysis of an opacified OFT CRYL? hydrophilic acrylic intraocular lens
摘要： A 51-year-old patient underwent posterior vitrectomy with perfluoropropane gas injection, phacoemulsification, and implantation of an Oft Cryl? hydrophilic acrylic intraocular lens (IOL) because of traumatic retinal detachment and cataract in the right eye. On the first postoperative day, gas was filling the anterior chamber because of patient’s non-compliance in terms of head positioning, and was reabsorbed within one week. Eight months later, the patient returned complaining of a significant decrease in vision. IOL opacification was noticed by slit-lamp examination. The lens was explanted to undergo gross and light microscopic analysis. The lens was also stained with the alizarin red method for calcium identification. Light microscopic analysis confirmed the presence of granular deposits, densely distributed in an overall circular pattern in the central part of the lens optic. The granules stained positive for calcium. This is the first case of the opacification of this type of hydrophilic lens. Surgeons should be aware of this potential postoperative complication, and the use of hydrophilic IOLs should be avoided in procedures involving intracameral gas because of the risk of IOL opacification.
关键词： Hydrophilic contact lens,Lens implantation,Vitrectomy,Intraocular lens,Capsule opacification
更新于2025-09-23 15:22:29
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Estimation of Intraocular Lens Power Calculation after Myopic Corneal Refractive Surgery: Using Corneal Height in Anterior Segment Optical Coherence Tomography
摘要： Purpose: To investigate the feasibility of estimating effective lens position (ELP) and calculating intraocular lens power using corneal height (CH), as measured using anterior segment optical coherence tomography (AS-OCT), in patients who have undergone corneal refractive surgery. Methods: This study included 23 patients (30 eyes) who have undergone myopic corneal refractive surgery and subsequent successful cataract surgery. The CH was measured with AS-OCT, and the measured ELP (ELPm) was calculated. Intraocular lens power, which could achieve actual emmetropia (Preal), was determined with medical records. Estimated ELP (ELPest) was back-calculated using Preal, axial length, and keratometric value through the SRK/T formula. After searching the best-fit regression formula between ELPm and ELPest, converted ELP and intraocular lens power (ELPconv, Pconv) were obtained and then compared to ELPest and Preal, respectively. The proportion of eyes within a defined error was investigated. Results: Mean CH, ELPest, and ELPm were 3.71 ± 0.23, 7.74 ± 1.09, 5.78 ± 0.26 mm, respectively. The ELPm and ELPest were linearly correlated (ELPest = 1.841 × ELPm – 2.018, p = 0.023, R = 0.410) and ELPconv and Pconv agreed well with ELPest and Preal, respectively. Eyes within ±0.5, ±1.0, ±1.5, and ±2.0 diopters of the calculated Pconv, were 23.3%, 66.6%, 83.3%, and 100.0%, respectively. Conclusions: Intraocular lens power calculation using CH measured with AS-OCT shows comparable accuracy to several conventional methods in eyes following corneal refractive surgery.
关键词： Intraocular lens power calculation,Corneal height,Corneal refractive surgery,Effective lens position,Anterior segment optical coherence tomography
更新于2025-09-23 15:22:29
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Unilateral Multifocal Intraocular Lens Implantation in a Patient with Adie’s Pupil
摘要： Purpose: To report a case of a patient with unilateral Adie’s pupil who underwent bilateral cataract extraction with multifocal and monofocal posterior chamber intraocular lens (IOL) implantation. Methods: A 74-year-old woman presented to our institution complaining of worsening near vision. Gross examination revealed a 6-mm fixed pupil on the right eye (OD) and a 5-mm pupil reacting to 3 mm with light on the left eye (OS). Slit lamp examination revealed a tonic pupil with an exaggerated pupillary constriction to dilute pilocarpine OD. Dilated exam revealed 2–3+ nuclear and cortical lens changes bilaterally. The patient’s active lifestyle, personality, and biometry measurements made her a good candidate for multifocal IOL (MfIOL) implantation OS. Femtosecond laser-assisted cataract extraction with a ReSTOR +3 ADD (SN60D1) implantation was performed OS. Monofocal lens implantation (SN60WF) was performed OD 6 months later. Results: One year postoperatively, our patient had an uncorrected visual acuity (VAsc) of 20/15 for distance and J10 for near OD. Her VAsc was 20/25 +1 for distance and J1 for near OS. Visual acuity when using both eyes was 20/15 for distance and J1 for near. Conclusion: Optimizing success for MfIOL implantation is a multifactorial process. Large pupils preoperatively are of particular concern, as this may lead to increased dysphotopsia with pupil-dependent MfIOLs. Thus, patients with unilateral mydriasis, such as Aide’s pupil, may have a beneficial outcome combining multifocal-monofocal implantation after bilateral cataract extraction, especially if they are not a candidate for monovision but desire spectacle independence.
关键词： Multifocal intraocular lens,ReSTOR,Tonic pupil,Adie’s pupil
更新于2025-09-23 15:22:29
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Rotational Stability and Patient Satisfaction after Implantation of a New Toric IOL
摘要： Purpose: To evaluate rotational stability, astigmatism correction, visual outcomes, and patient satisfaction after implantation of the toric intraocular lens (IOL) Torica-aA following cataract extraction over a 6-month follow-up period. Methods: This prospective observational study enrolled 40 eyes of 26 patients presenting with preexisting corneal astigmatism of 1.00 to 2.60 D. The rotational stability of the IOL was evaluated using retroillumination photographs taken within 24 hours after surgery and 1 week and 6 months postoperatively. Other main study outcomes were assessed 6 months postoperatively and included uncorrected and distance-corrected visual acuities, astigmatism correction, and patient satisfaction. Results: Six months postoperatively, mean absolute IOL rotation was 1.99 ± 1.88° (range 0.10-7.40°) and secondary repositioning was not required. The IOL rotation was <3° in 85% of eyes, ≤5° in 94% of eyes, and <8° in 100% of eyes. Mean residual refractive cylinder was -0.57 ± 0.34 D. The magnitude of the J0 vector was significantly decreased postoperatively (p<0.0001). The mean J45 vector was close to zero preoperatively and postoperatively (p = 0.27). Mean monocular uncorrected distance visual acuity (UDVA) was 0.09 ± 0.12 logMAR and 97% of eyes achieved UDVA of 20/40 or better including 66% of eyes having 20/25 or better. The good UDVA resulted in high levels of spectacle independence and patient satisfaction. conclusions: Implantation of the Torica-aA IOL was safe and effective in reducing low to moderate preexisting corneal astigmatism and provided good rotational stability and refractive outcomes, which led to a high degree of patient satisfaction.
关键词： Hydrophilic acrylic,Astigmatism,Intraocular lens,Toric IOL,Cataract,Rotational stability
更新于2025-09-23 15:21:21
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Comparative Analysis of the Safety and Functional Outcomes of Anterior versus Retropupillary Iris-Claw IOL Fixation
摘要： Purpose. To compare the functional and clinical outcomes of the iris-claw intraocular lens (IOL) placed on the anterior versus posterior surface of the iris. Patients and Methods. A multicenter, retrospective study. Data on eyes that underwent anterior or retropupillary iris-claw IOL implantation because of inadequate capsular support secondary to complicated cataract surgery, trauma, and dislocated/opacified IOLs since January 2015 were analyzed. For study inclusion, evaluation results had to be available in the medical records both preoperatively and at 1 and 12 months after implantation. The following parameters were compared between the groups: best-corrected distance visual acuity (BCDVA), spherical and cylindrical refractive error, endothelial cell density (ECD), central macular thickness (CMT), and percentage and type of postoperative complications. Results. In total, 60 eyes of 60 patients aged 73 ± 13 years were included: 28 eyes (47%) involved anterior, and 32 eyes (53%) retropupillary, iris-claw IOL fixations. Preoperatively, the groups were similar in all parameters except for a significantly higher proportion of retropupillary fixations in patients who had previously experienced a closed-globe trauma (p ? 0.03). The groups showed comparable improvements in BCDVA after surgery (final BCDVA: 0.34 ± 0.45 vs. 0.37 ± 0.50 logMAR in the anterior and retropupillary placement groups, respectively). During follow-up, no group difference was observed in refractive error or CMT. Both groups experienced similarly marked ECD loss and showed similar incidence of postoperative complications, with cystoid macular edema being the most common complication. Multivariable linear regression showed that BCDVA at 1 month was the best predictor of the final BCDVA. Conclusions. Anterior chamber and posterior chamber iris-claw IOL fixations proved equally effective and safe for aphakic correction in eyes with inadequate capsular support.
关键词： iris-claw intraocular lens,anterior chamber,aphakia,posterior chamber,capsular support
更新于2025-09-23 15:19:57
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Axial length estimation error caused by hidden double-peak on partial coherence interferometry in an eye with epiretinal membrane: a case report
摘要： Here we report a patient in whom there was a myopic shift after combined cataract surgery and pars plana vitrectomy against the epiretinal membrane, related to axial measurement estimation error caused by a hidden double-peak appearance on partial coherence interferometry measurement. A 52-year-old female presented with epiretinal membrane and underwent combined cataract surgery and pars plana vitrectomy. Axial length was measured with partial coherence interferometry. Although the signal curve in the summary display showed a single peak, a 1.6 diopter myopic shift occurred. Viewed retrospectively, six of 20 individual signal curves showed a double peak. Most of them showed a higher anterior peak, with only one having a higher posterior peak. The other 14 curves showed a single peak at a similar distance to an anterior peak. The anterior peak appeared to be derived from the epiretinal membrane. The possibility of a double peak should always be considered in patients with epiretinal membrane even if the summary display of the partial coherence interferometry measurement shows a single peak. Checking all signal curves would reduce the risk of missing a hidden double peak.
关键词： master,intraocular lens,epiretinal membrane,double peak
更新于2025-09-19 17:15:36
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Effectiveness of intraoperative intraocular lens use on improving surgical safety for dense cataract phacoemulsification: a randomized controlled trial
摘要： We designed this study to assess if surgical safety can be improved by intraoperative use of intraocular lens (IOL) for cataract phacoemulsification. We performed phacoemulsification cataract removal on 401 patients. We randomly assigned these patients into three groups: the standard setting (Group I, n = 134), with reduced vacuum and flow rate (Group II, n = 137), and with IOL insertion before the last quadrant was emulsified with standard setting (Group III, n = 130). The primary outcomes included the risk of posterior capsular rupture (PCR), ultrasound time, energy, and complications. The secondary outcomes included central corneal thickness (CCT), CCT changes, endothelial cells (ETC) counting, ETC loss, and the best corrected distance visual acuity (BCVA) measured on day 1, day 7 and day 30. If PCR occurred, we emulsified the residual lens materials after insertion of IOL and clean of the prolapsed vitreous. We found that the risk of PCR in Group III (0/130) was lower than Group I (9/134, corrected relative risk (RR) = 18.44, 95% CI: 1.08–313.56) and Group II (3/137, corrected RR = 6.64, 95% CI: 0.35–27.41). Group III showed better BCVA on day 1 and 7, less ECC loss on day 7 and 30, and less CCT increase on day 1 and 7. No cases converted to extracapsular cataract extraction. No residual lens materials misdirected into vitreous cavity. Intraoperative use of IOL can improve surgical safety for dense cataract phacoemulsification.
关键词： cataract phacoemulsification,intraocular lens,surgical safety,posterior capsular rupture,ultrasound time,endothelial cells loss,central corneal thickness
更新于2025-09-19 17:13:59